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The development of a clinically useful tool for predicting the development of psychological disorder following injury

Mason, S., Farrow, T.F.D., Fawbert, D., Smith, R., Bath, P.A., Hunter, M., Woodruff, P.W. and Turpin, G. (2009) The development of a clinically useful tool for predicting the development of psychological disorder following injury. British Journal of Clinical Psychology, 48. pp. 31-45. ISSN 0144-6657

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Abstract

Objectives. To identify factors significantly associated with post-traumatic stress disorder (PTSD), anxiety, and depression at 3 months post-injury; to develop a generic model to predict the occurrence of PTSD, anxiety, and depression at 3 months postinjury; and to validate this model in a test data set of patients. Design. Prospective cohort study.

Methods. Participants were 823 patients attending an emergency department (ED) following accidental injury. Baseline questionnaires were completed, with 1 and 3 months postal follow-ups. Predictor variables demonstrating significant associations with two of the three outcome measures (3-month HAD anxiety and depression scores and PTSD symptoms) were included in multivariate regression models for each outcome. Non-significant predictor variables were removed until all remaining independent variables made the most significant contribution to each of the three models. Models were validated using a test dataset.

Results. Previous history of mental health problems, neuroticism score and having PTSD symptoms at 1 month predicted adverse outcomes at 3 months. When used on the test datasets, the areas under the receiver operating curve (ROC) curve for the models predicting outcomes at 3 months were: PTSD 0.91 (sensitivity 88.5%); anxiety 0.87 (sensitivity 93.7%); and depression 0.87 (sensitivity 96.7%).

Conclusions. The final model performed moderately well across the three outcomes and may be useful clinically as a generic rule-out tool to identify those who will not require follow up, watchful waiting or intervention.

Item Type: Article
Keywords: POSTTRAUMATIC-STRESS-DISORDER; RANDOMIZED CONTROLLED-TRIAL; MOTOR-VEHICLE ACCIDENTS; 2-YEAR PROSPECTIVE EVALUATION; SELF-HELP INFORMATION; TRAUMATIC INJURY; VIOLENT CRIME; RISK-FACTORS; VICTIMS; PTSD
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Social Sciences (Sheffield) > Information School (Sheffield)
Depositing User: Information Studies
Date Deposited: 14 Aug 2009 10:29
Last Modified: 14 Aug 2009 10:29
Published Version: http://dx.doi.org/10.1348/014466508X344799
Status: Published
Publisher: British Psychological Society
Identification Number: 10.1348/014466508X344799
URI: http://eprints.whiterose.ac.uk/id/eprint/9088

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